Maine DHHS chief: Medicaid expansion ‘unsustainable’

Gov. Paul LePage’s health and human services chief told Portland-area business leaders Wednesday that Maine should not expand its Medicaid program through the federal health care law.

Health and Human Services Commissioner Mary Mayhew was the keynote speaker at the Portland Regional Chamber’s Eggs ‘N Issues breakfast. She focused on making the case against expanding Medicaid, at a time when the department is dealing with controversies including a plan to move its Portland offices to South Portland, a failing rides system for Medicaid recipients and the hiring of an out-of-state contractor to evaluate its public benefits system.

Additional Photos

Mary Mayhew, commissioner of the Maine Department of Health and Human Services, speaks at the Portland Community Chamber’s Eggs ’N Issues breakfast at Holiday Inn By the Bay in Portland Wednesday. John Patriquin / Staff Photographer

Medicaid expansion, a key component of the Affordable Care Act, is a partisan issue in state houses across the country, including Maine. Most Republican administrations, including LePage’s, have opposed expansion, a strategy that coincides with other efforts to resist implementation of the federal health care law.

LePage vetoed two legislative efforts to expand Medicaid earlier this year. Democrats, who have majorities in the Legislature, will try again when lawmakers reconvene for an emergency session in January.

Both sides in the debate have intensified their public relations campaigns over an issue that may play into the 2014 legislative and gubernatorial elections. Additionally, President Obama has begun pressuring Republican governors to expand Medicaid.

In Maine, advocates say expansion would provide health insurance to more than 60,000 low-income residents, with the federal government paying 100 percent of the expansion costs before gradually drawing down to 90 percent reimbursement.

Mayhew said the budget turmoil this year in Washington, D.C., should be a warning against assuming that the federal government will be able to keep its funding promise. Even if the federal dollars arrived as promised, she said, the state would pay $150 million a year.

Mayhew also drew a rhetorical link between the state’s reliance on federal dollars and a welfare system that should not be “the goal or the finish line” for beneficiaries. She said Maine should evaluate its “insatiable appetite for federal dollars, in particular Medicaid dollars,” which have “blurred lines” between assistance and “dependency.”

House Speaker Mark Eves, D-North Berwick, said in a written statement that Mayhew’s speech was a continuation of her department’s “effort to deny and delay health care to tens of thousands of working Mainers, including nearly 3,000 veterans.”

In her remarks before the business community, Mayhew said the state’s current $2.4 billion in Medicaid spending takes most of the DHHS’ $3.4 billion annual budget.

She said previous expansions have put the most needy on waiting lists for coverage. And, she said, the program creates “annual shortfalls of tens of millions of dollars” and is “perpetually suffering from financial challenges.”

Eves responded by saying, “Businesses in Maine know that accepting federal health ccare dollars to cover working Mainers is a good deal. No business leader would turn away an additional $700,000 a day for their company because of politics. But that’s what Gov. LePage is doing. Starting on Jan. 1, Maine will lose out on an additional $700,000 a day while nearly 25,000 Mainers lose care.”

PLANNED MOVE HOTLY DEBATED

The DHHS is the subject of controversies that include a plan to move its Cumberland County regional office from Marginal Way near downtown Portland to a site nearly four miles away, near the Portland International Jetport. Opponents say the move would make it harder for people who seek public assistance to get it.

On Tuesday, Democratic Senate President Justin Alfond joined city leaders and advocates for the poor to protest the plan, calling it the governor’s latest move in his “war on the poor.”

After her speech Wednesday, Mayhew said Alfond’s comment was “appalling,” and the governor is committed to ending “generational poverty” and building a sustainable welfare system that ensures the most needy get services.

During a radio interview with WGAN on Wednesday morning, she defended LePage’s welfare policies, saying his “heart is in the right place.”

She said the Portland office move is designed to consolidate public assistance with services of the Department of Labor, to help the needy get off public assistance and into employment. The administration says the move would save the state about $14 million.

The state’s lease on Marginal Way expires Jan. 31, 2015. The state is still negotiating the terms of a 20-year lease with ELC Management Inc., which would build the office building near the airport. The parcel is undeveloped, leaving questions about whether the building would be ready in time for the move.

Mayhew would not answer questions about whether the timetable is realistic, referring them to the Department of Administrative and Financial Services, which oversaw the site selection.

WELFARE STUDY OFF TO SLOW START

After her speech, Mayhew also addressed the administration’s decision to sign a $925,000 contract for a consultant to evaluate Maine’s Medicaid and welfare programs. Critics say the evaluation is designed to validate proposals that the LePage administration embraces. Gary Alexander, the principal of the consulting group, has come under fire for implementing reforms while he was the welfare chief in Pennsylvania that an auditor general’s report found cost taxpayers $8 million more than necessary.

The first installment of the Maine study, an analysis of Medicaid expansion, was due Dec. 1. DHHS officials confirmed Monday that the Alexander Group had not yet delivered its analysis. Mayhew hinted Wednesday that the deadline was missed partially because the state had not provided all the information needed for the analysis. She said she hopes the review will be delivered within the “next week or so.”

NO ANSWERS ON RIDES PROGRAM

Mayhew also was asked about the DHHS’ $28.3 million contract with a Connecticut company to arrange rides for Medicaid patients.

Coordinated Transportation Solutions is at the center of a controversy over a system that has left thousands of patients without rides since it started Aug. 1.

DHHS officials told CTS that it had until Dec. 1 to submit a corrective action plan and make improvements.

Mayhew twice declined to answer whether the company has a deadline to show it is acting on that improvement plan.

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